To listen to these shows, which aired on BBC 4 radio in January of 2011, go to this page, click on "show all episodes" and scroll down- they (parts 1 and 2) are towards the bottom of the page. Here are my notes of some things that caught my attention from Part 1:
Peter Aaby is a Danish anthropologist who has been working in Guinea Bissau, a nation with some of the worst health statistics in the world, for at least 30 years. He has been researching vaccines and their effectiveness during this time, trying to figure out what works and what doesn't. He has been looking at the long-term effects of vaccination and noticed that micronutrients and vaccines may have far-reaching and unforeseen effects, that can determine a child's survival. The question is raised about how the many vaccines given may be interacting with each other an causing unforeseen effects. It is important to note that he is NOT anti-vaccine- he began his scientific career in Guineas Bissau by demonstrating that the extremely high child mortality rate was from disease, not from malnutrition, and set out believing that vaccines were the solution.
One person interviewed in the story says of Peter Aaby's work "If it all gets accepted in the end, and proven, it will be a paradigm shift in the way we think about vaccinating children...and paradigm shifts in the scientific community are very frightening". Another person in the podcast says that the question of whether vaccination could be done differently, could be done better, is really threatening the whole system of vaccination.
One thing that he has noticed is that the order of vaccines can make a difference, and which one was last administered before an illness sets in. For example, if a girl comes into the hospital with pneumonia, she is more likely to survive if her last vaccine was for measles rather than DPT. The chances of fatality depend on the vaccination stages. The narrator of the show says that a recent editorial in the BMJ compared Peter Aaby to Galileo , which is profoundly ironic because this show aired the week that the BMJ ran papers by Brian Deer claiming that Dr Wakefield's work was fraud. The report goes on to say that while some scientists see him as a risk to the global vaccination system, the lives of tens of millions of children are at stake.
The report discusses Peter Aaby's involvement with a WHO trial for a new measles vaccine. The original results looked good- the vaccine seemed to work- but he decided to leave the study open to see what the long-term effects of the vaccine were on the community, to see whether t actually reduced mortality, a thing that few if any vaccine researcher had ever done before. What he found is that girls who had received the vaccine were dying at much higher rates, not from measles, but from other infections. The vaccine seemed to have a detrimental effect on the immune system of girls. The WHO withdrew the new vaccine, which they say may have saved tens of thousands of lives. After studying why this had happened, he discovered that it was the result not of the new measles vaccine itself, but of its interaction with the DPT vaccine (this is one of the most widely given vaccines in the developing world). He believes that the DPT is weakening the immune system of girls and increasing the rate of death 50% above what it would otherwise be.
The WHO sent a team to review Peter Aaby's findings, led by Kim Mullhulland, who found nothing wrong with the research. Kim Mullhulland is now a professor at the world-renowned London School of Hygiene and Tropical Medicine. He says that when he returned to WHO headquarters, officials there were dissapointed that he had not found problems with the data or research. He says he was never asked to present his findings and there was not much interest shown to what he had found, which surprised him. He says that he realized that "our findings were not well received". While Kim Mullhulland's team concluded that the results of Peter Aaby's studies were reliable, and could not be explained by error, the WHO took an official position that the findings could neither be confirmed nor denied, and that no further action was necessary. Kim Mullhulland says he is deeply troubled by the lack of action on the part of the global community to further research or act on what could be causing an alarming rate of mortality around the world.
When asked, Peter Smith, who is the chair of the WHO's Global Advisory Committee on Vaccine Safety, said of the potential risk of DPT "I think the evidence for the deleterious effects of DPT, in those settings (high mortality settings) is not totally convincing". When asked if it is fairly convincing, he responds "it's sufficient to justify further study". He then tries to clarify that the evidence is not convincing, but that he is not saying that the effect does not exist. He also says, and this deserves a drum roll..."I mean, one has to keep a reasonable open mind with respect to any adverse effects of vaccines".
The narrator says that "all of the scientists I spoke to said that they were also nervous about speaking publicly in case it set off a fresh vaccine scare". Kim Mullhulland says that immunization as a package has been immensely beneficial to the world;s children, "whether we could be doing it better, whether we could be using vaccines more efficiently or in a different way..or in a safer way...those are the questions that we're dealing with here". The narrator also points out that possibly re-ordering the vaccine schedule could mitigate unintended negative consequences. He also says that the "wider issue is the way that all vaccines and vitamin supplements may affect the immune system in unpredictable ways".
Peter Smith of the WHO Vaccine Advisory Committee points out that because no one else has done this kind of research, or looked at long term effects of vaccines, nearly all of the data has been amassed by Peter Aaby and his team, which causes some to be suspicious of it- calling it an "Aaby effect". This problem may be resolving itself, as "36 leading scientists have formed a group calling for a much closer look at the non-specific effects of vaccines" including Katie Flannagan (who is an immunologist for the British Research Council and a lecturer at the Imperial College of London), who says "in fact, surprisingly we know very little about how many of the commonly used vaccines actually work. Also, the developing immune system in a baby has for many years been very difficult to study, because it's very difficult to get blood samples from these children." She is looking for biological evidence of Peter Aaby's findings. Her findings are that "we are seeing clear differences in the actual inflammatory profile if you give the vaccines together, the DTP and the measles, compared to giving measles alone, and the effects are completely different in boys and girls". She goes on to say that she is seeing clear immunological patterns supporting Peter Aaby's findings.
